The Department of Public Welfare in Harrisburg says most of the people cut were dead, had moved out of state, or were found to be ineligible, but it could provide no breakdown. Advocacy groups, clients, and representatives for caseworkers paint a different picture. Pressure to quickly review a backlog of files and close cases overwhelmed the system, they say, as reams of paperwork were lost and computer programs automatically ended benefits when patients' responses had not been entered by preset deadlines.
The Pennsylvania experience, while extreme, illustrates the difficulty of reining in increases in health-care costs nationwide. For the short term, the cost of providing public insurance ballooned as people lost their jobs and employer-provided benefits, while states' belt-tightening reduced the workforce that processes applications.
Marie Stopa of Holmesburg received a letter Sept. 15 saying her four children would be cut off Sept. 19 if renewal paperwork was not received. She says she sent it the next day, but benefits were cut off anyway. Her 10-year-old son, Marek, has landed in emergency rooms twice since then for asthma attacks Stopa believes would have been avoided had he remained on the preventive medication she can no longer afford.
The $2,100 in ER bills is unpaid. The state will retroactively cover the costs if her insurance is restored, which Public Citizens for Children and Youth, the advocacy group on her case, believes will happen. Advocates say this case is an example of how attempts to save money may end up costing the state more instead.
